Deck 3: Content of the Health Recordadministrative Data

Question 1

Clinical Documentation Architecture (CDA) and Quality Reporting Documentation Architecture (QRDA) are both specific data standards of the broader _________ standards.

A) Health Level Five (HL5)
B) Health Level Six (HL6)
C) Health Level Seven (HL7)
D) Health Level Eight (HL8)

Answer 1

Health Level Seven (HL7)

Question 2

Daniel Allen has been a patient at Greenway Hospital for the following ailments: January 8, 2012, inpatient for appendicitis; April 16, 2012, emergency department for an asthma attack; May 12, 2013, urgent care for a viral illness; May 13, 2013, inpatient for pneumonia; and June 4, 2013, emergency department for a sprained arm. How many times will Daniel Allen's name and demographic information be entered in the MPI of Greenway Hospital?

A) one
B) three
C) four
D) five

Answer 2

one

Question 3

The name, address, NPI number, and telephone number of a physician is known as ____________ information.

A) subscriber
B) policyholder
C) identification
D) provider

Answer 3

provider

Question 4

In a hospital, what piece of data is included in the Master Patient (Person) Index (MPI) that allows a hospital to locate the corresponding health (medical) record for each patient?

A) patient's full name
B) Social security number
C) Date of admission
D) medical (health) record number

Question 5

Dr. Glover's office has one vendor for their practice management software and another for their electronic health record, but the systems are able to communicate with one another without duplicating data entry. The systems are able to

A) interchange.
B) duplicate.
C) interface.
D) standardize.

Question 6

The required code set for documenting diagnoses on all patients in any care setting is known as

A) CPT.
B) HCPCS.
C) ICD-10-CM.
D) ICD-10-PCS.

Question 7

Demographic data is a subset of ____________________ data.

A) clinical
B) administrative
C) medical
D) billing

Question 8

Greenway Medical Center has partnered with five area physician's offices as well as a rehabilitation facility nearby for the purpose of offering high-quality, coordinated care to patients in that geographic area. This partnership is known as a/an _________________.

A) Health Maintenance Organization
B) Health Insurance Exchange
C) Accountable Care Organization
D) Managed Care Organization

Question 9

Daniel Allen has been a patient at Greenway Hospital for the following ailments: January 8, 2012, inpatient for appendicitis; April 16, 2012, emergency department for an asthma attack; May 12, 2013, urgent care for a viral illness; May 13, 2013, inpatient for pneumonia; and June 4, 2013, emergency department for a sprained arm. How many encounters for Daniel Allen will be found in the MPI of Greenway Hospital?

A) one
B) three
C) four
D) five

Question 10

Where do the data originate that are used to prove Accountable Care Organization (ACO) success?

A) a federal government database
B) the insurance exchanges
C) the Master Patient Index
D) the patients' health records

Question 11

Susan is collecting data from a patient, and she asks him for his address. The patient asks whether she means his P.O. box number or his physical street address. Susan would find the meaning of the field permanent address in the practice's ______________________.

A) library
B) thesaurus
C) master list
D) data dictionary

Question 12

In order for ACOs to prove that they have provided quality care while controlling costs, what is/are necessary?

A) additional staff
B) ancillary services (lab, radiology, rehab, etc.) available 24/7
C) data
D) one health record for each patient regardless of which provider or facility within the ACO is utilized

Question 13

The subscriber and patient information section of a claim form includes all of the following except

A) assignment of benefits authorization.
B) policyholder's name.
C) policy number.
D) patient's relationship to the policyholder.

Question 14

You are about to enter the marital status of a patient, and upon clicking in that field, the following appears: These possible values are derived from a _____________ within the system.

A) master list
B) dictionary
C) library
D) value list

Question 15

There are certain pieces of data that must be collected in order to meet Meaningful Use requirements. Which data element below does that?

A) patient's race
B) patient's address
C) provider's address
D) patient's vital signs

Question 16

The setting where services took place is known as ______________________.

A) a unique identifier
B) the policyholder's address
C) the place of service code
D) the hospital

Question 17

Michael Malone's health (medical) record number at Memorial Medical Center is 482638. This is an example of a/an ______________________.

A) index number
B) provider number
C) unique identifier
D) account number

Question 18

In order to file a claim to Medicare, a physician's office submits a ___________ form.

A) CMS-1500
B) HCFA-1500
C) UB-02
D) UB-04

Question 19

A major goal of using an electronic health record is the sharing of important clinical information about a patient. The use of ________________________ is directly related to this goal.

A) Clinical Documentation Architecture (CDA)
B) Continuity of Care Documents (CCD)
C) Quality Reporting Document Architecture (QRDA)
D) Transfer summaries

Question 20

The Master Patient (Person) Index is

A) a listing of office visits for each patient within a practice.
B) an index of all patients ever treated in a hospital.
C) a chronological list of all patients seen during a given time period.
D) an index of all patients seen in a hospital, sorted by date of admission.

Question 21

Part of the payer information required by HIPAA includes a ______________ number that is obtained when an insurance plan requires procedures to be approved in advance of the procedure being done.

Question 22

The amount of time allotted for a patient's office appointment is largely dependent on the _______________________.

A) reason for the visit
B) the amount of time open on the schedule for that day
C) the amount of time requested by the patient
D) whether this is an established or new patient

Question 23

There are many different service providers that provide healthcare-related software. In order for these software packages to interface (communicate) with one another, ____________ standards are followed.

Question 24

What terminology is used to refer to the permanent record, sorted by patient name, of all patients treated at a physician's practice?

Question 25

Each staff member must collect data from patients consistently. What is used to explain the intent of each data field?

Question 26

Charles Channing works for the Carrollton Daily Herald. He is the policyholder of the group insurance plan. What is another term used to refer to the policyholder?

Question 27

Amy Shaw arrives for her appointment at Dr. Rodriguez's office. She has moved since her last visit and her last name has changed due to her marriage. What will the healthcare professional do to the patient's demographic information in Prime Suite, if anything?

Question 28

In a physician's practice, the index of all patients seen in that practice is most commonly known as the

A) MPI.
B) account index.
C) patient list.
D) case file.

Question 29

The patient's full name, marital status, gender, date of birth, and a unique identifier are just a few of the core data elements recommended by which agency?

Question 30

A patient at Heller Memorial Hospital, Lisa Ford, was a patient in the emergency department in 1998 and has had outpatient lab work in 2003 and 2005; she was then married. Her name changed to Lisa Ford Haver, and she had her twins at Heller County Memorial Hospital in 2010. How many times will her name and demographic information appear in the hospital's MPI?

A) once
B) twice
C) four times
D) five times

Question 31

The step that occurs after a patient is seen by the care provider is

A) patient checks in at the front desk.
B) billing process begins.
C) patient stops at the cashier or check-out desk.
D) patient is seen by the clinical support team.

Question 32

In a hospital setting, which code system converts narrative operations and procedures into coded format?

Question 33

In which healthcare setting is a patient registered prior to receiving care?

A) acute care hospital
B) physician's office
C) dental office
D) both acute care hospital and dental office
E) patients are registered in all of these settings

Question 34

When certain fields are clicked, the most common response to that field may appear. This is known as a _________ value.

A) typical
B) default
C) library
D) dictionary

Question 35

At Heller Memorial Hospital, all patients, regardless of the type of patient, emergency department, inpatient, outpatient diagnostics, etc., are registered through the same department. This is known as:

A) departmental registration
B) centralized registration
C) decentralized registration
D) admissions

Question 36

Carolyn Ware is a billing coordinator at Memorial Hospital. She files claims for all patients using which form?

Question 37

The MPI and patient list should be kept

A) five years.
B) ten years.
C) twenty-five years.
D) permanently.

Question 38

Each time a patient presents for care, the ______________ should be viewed or copied to ensure accurate information is on file for billing purposes.

A) insurance card
B) driver's license
C) previous health records
D) patient history form

Question 39

What is the name of the coding system used to convert diagnoses into a coded format?

Question 40

Virginia Reed called Greensburg Medical Center to make an appointment for her annual physical exam. This step in the process is called

A) registration.
B) scheduling.
C) editing.
D) check-in.

Question 41

Explain what "search the MPI (or patient list)" means.

Question 42

Why would collecting race or ethnicity information be considered a meaningful use of data?

Question 43

Explain ways that medical practices may have patients communicate changes in their demographic information.

Question 44

Explain what is meant by different ACO models and what reimbursement is dependent on for an ACO, regardless of the model.

Question 45

Explain the significance of a unique identifier for each patient in a hospital setting.

Question 46

What are the advantages to a facility of selecting software that is able to communicate among different applications?

Question 47

It is best practice to keep a current copy of a patient's insurance card on file at each visit. In an electronic system, the healthcare professional may do what to the card to make a digital image, which will then reside in the practice management system?

Question 48

Why would a library of possible answers be advantageous within electronic health record systems?

Question 49

The registration process takes place in which software application within Prime Suite?

Question 50

Explain what a (+) sign means when seen to the left of a menu item.

Question 51

Describe the specific standards now recognized by HL7.

Question 52

Pose two situations in which the length of time allotted for an appointment will be affected by the reason for the appointment.. Explain your answer.

Question 53

List and define the term for what records are filed by in a hospital setting. In addition, indicate how this may relate to the MPI?

Question 54

Explain the purpose of a Continuity of Care Document (CCD).

Question 55

County Hospital offers inpatient, outpatient diagnostic laboratory, emergency department, and ambulatory surgery services. Each of these services has its own registration area. What kind of registration does County Hospital use?

Question 56

Differentiate between scheduling an appointment and registering a patient at a doctor's office.

Question 57

What type of impact might ACOs have on care providers?

Question 58

As fields are completed in the practice management part of Prime Suite, that same information is also being populated in the corresponding fields in the electronic health records part of Prime Suite. What makes that possible?

Question 59

List some of the common features you might use with the Prime Suite Help function that connects you to the User's Manual.

Question 60

In a multiprovider practice, when making an appointment with a particular care provider, what is the first step to finding an open appointment?

Question 61

How does the use of default values save time for the office staff? Give an example.

Question 62

Explain the concept of "cross-referencing" patients in the MPI or patient list. Give an example.

Question 63

You are an office manager in Greensburg Medical Center. You have a new receptionist starting this week. You want him to become familiar with Greenway Medical Technologies' Prime Suite applications. You have meetings scheduled, so you need to give him materials to read. What does Prime Suite offer that will allow you to give him accurate, complete information about its applications?